Credit Application Hollywood Casino Perryville


*  Indicates field is required
Personal Information

Personal Information






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lbs
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kg

Trip Information

Trip Information

$

Employment Information

Employment Information

$

New Jersey Gaming Declaration

Are you a gaming related casino employee, a state officer or employee, member of judiciary or legislature, or an officer of a municipality or county in New Jersey?


Financial Information

Financial Information
$
$
$
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$
Primary Bank Information

Bank Account #1

Pre-paid debit and credit cards are not valid options.
 * Applicant must be the sole proprietor of this account
Secondary Bank Information

Bank Account #2

Pre-paid debit and credit cards are not valid options.
 * Applicant must be the sole proprietor of this account


Gaming Information Other Casino Credit

Gaming Information Other Casino Credit




License Agreement

Before Drawing on my line of credit, if granted, I agree to sign credit instruments (i.e. checks) in the amount of each draw. I authorize Hollywood Casino Perryville to complete any of the following missing items on these credit instruments: (1) the name of the payee; (2) any missing amounts; (3) a date; (4) the name, account number and /or address and branch of any bank or financial institution; and (5) any electronic encoding of the above items. This information can be for an account from which I now have or may in the future have to the right to withdraw funds, regardless of whether that account now exists, or whether I provide the information on the account to Hollywood Casino Perryville. I also authorize Hollywood Casino Perryville to deposit outstanding credit instruments to said bank or financial institutions.

I authorize Hollywood Casino Perryville to investigate and verify my bank or financial institution information. Therefore, I authorize my bank or financial institution to release information including, but not limited to, the current and average balance of my accounts; the open date of the account and any information deemed relevant to my credit worthiness.

I authorize Hollywood Casino Perryville to investigate my credit report and to furnish information concerning such credit reports to credit reporting agencies and others who may properly receive this information. I authorize Hollywood Casino Perryville to conduct such investigations pertaining to the above information, as it deems necessary for the approval of my credit limit.

I agree that each draw against my credit line is a separate advance of money by Hollywood Casino Perryville. If I receive the advance before I execute a credit instrument, I promptly will sign a credit instrument in the amount of the advance.

I certify that I have reviewed all of the information provided above and that it is true and accurate and I may be subject to civil or criminal liability if any material information provided by me is willingly false. (I am aware that this application is required by the Gaming Regulations regulated by the Maryland State Lottery.)

I hereby authorize Hollywood Casino Perryville, in its sole discretion, to apply all chips I may redeem first to the reduction of any outstanding debt, with the remainder, if any, to be returned to me.

I agree that this application and all credit issued pursuant thereto will be governed, construed and interpreted pursuant to the laws of the State of Maryland and venue shall lie solely in that State. I agree that Hollywood Casino Perryville may litigate any dispute involving the credit line, the debt or the payee in any court, State or Federal, in Maryland.

I further represent that I have not been excluded from any gaming operation, nor have any of my privileges at any gaming operation been restricted, either voluntary or by action of law. I also certify that I am at least 21 years of age.

Privacy Policy

Click here to view the Hollywood Casino Perryville Privacy Policy.

Click here to view the Privacy Policy for VisuaLimits, LLC

Signature

I, the undersigned, hereby authorize and instruct Hollywood Casino Perryville and its agent VisuaLimits, LLC ("VL") and its affiliates to obtain consumer reports, to contact financial institutions, and to check my consumer credit, employment, bank and gaming history in order to evaluate my credit application as well as to update and/or review my account to provide services requested by me, as necessary or as required by law. I authorize Hollywood Casino Perryville, VL or its affiliates to verify such information through any source and to report any information to another casino, excluding credit report data obtained from a credit agency, and to exchange any information with any of the affiliates of the Company. I hereby release and waive, and agree not to bring at any time in the future, any claims or demands against VL or its affiliates relating to any credit investigation made pursuant to my authorization and instructions herein, including, without limitation, the collection, processing, and transmission of my information and data.

VisuaLimits, LLC ("VL") promotes responsible gambling. By entering my name in the signature field and clicking the "I Accept" button below, I acknowledge that I have read the VisuaLimits, LLC Responsible Gaming Policy.

By entering my name in the signature field and clicking the "I Accept" button below, I hereby represent, warrant, and agree that all information provided herein is true and correct, that I am the person for whom I am requesting credit, and that I have read, understand, and agree to be bound by all of the terms herein.

I hereby acknowledge and agree that this Application may be signed electronically and that such electronic signatures shall be deemed an original for all purposes. I represent and warrant that by signing this Application electronically or causing this Application to be signed electronically that I have the authority to do so and that such electronic signature shall be sufficient to bind the respective party under this Application.